Brier Moriah J, Chambless Dianne L, Lee Laura, Mao Jun J
Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania.
Washington University School of Medicine, St. Louis, Missouri.
Cancer. 2015 Aug 15;121(16):2808-13. doi: 10.1002/cncr.29407. Epub 2015 Apr 29.
Breast cancer survivors on aromatase inhibitors often experience joint pain as a side effect of their treatment; qualitative investigations suggest that this arthralgia may cause women to feel that they are aging faster than they should be. To facilitate further study of this experience, the Penn Arthralgia Aging Scale (PAAS) was developed. This report describes the development and validation of the PAAS in a racially diverse sample of breast cancer survivors suffering from joint pain.
The items of the scale were developed from a content analysis of interviews with patients. The scale was pilot-tested, and modifications were made on the basis of patient feedback. Subsequently, 596 breast cancer survivors who endorsed joint pain completed the 8-item PAAS. The factor structure (with exploratory factor analysis), the internal consistency, and the convergent, divergent, and incremental validity were examined.
The resulting scale had a 1-factor structure with strong internal consistency (Cronbach's α = .94) and demonstrated both convergent and divergent validity: the PAAS was significantly correlated with joint pain severity (rs = 0.55, P < .01) and had a small and nonsignificant correlation with actual age (rs = -0.07, P = .10). The PAAS was also found to explain incremental variance in anxiety, depression, and pain interference outcomes.
These findings suggest that the PAAS produces reliable and valid scores that capture perceptions of aging due to arthralgia among breast cancer survivors. With further research, the PAAS may advance our understanding of how perceptions of aging may affect breast cancer survivors' emotional, behavioral, and clinical outcomes.
接受芳香化酶抑制剂治疗的乳腺癌幸存者常常经历关节疼痛，这是其治疗的副作用；定性研究表明，这种关节痛可能会让女性感觉自己衰老得比正常情况更快。为便于进一步研究这种体验，研发了宾夕法尼亚关节痛衰老量表（PAAS）。本报告描述了PAAS在患有关节痛的种族多样化乳腺癌幸存者样本中的开发与验证过程。
该量表的条目是通过对患者访谈的内容分析得出的。对该量表进行了预测试，并根据患者反馈进行了修改。随后，596名认可存在关节痛的乳腺癌幸存者完成了包含8个条目的PAAS。对其因子结构（采用探索性因子分析）、内部一致性以及收敛效度、区分效度和增量效度进行了检验。
最终形成的量表具有单因子结构，内部一致性很强（Cronbach's α = 0.94），并显示出收敛效度和区分效度：PAAS与关节痛严重程度显著相关（rs = 0.55，P < 0.01），与实际年龄的相关性较小且不显著（rs = -0.07，P = 0.10）。还发现PAAS能够解释焦虑、抑郁和疼痛干扰结果中的增量方差。
这些发现表明，PAAS能够产生可靠且有效的分数，用以捕捉乳腺癌幸存者中因关节痛而产生的衰老认知。随着进一步研究，PAAS可能会增进我们对衰老认知如何影响乳腺癌幸存者的情绪、行为和临床结果的理解。
